Surgical simulation device and assembly

ABSTRACT

A system for simulating a surgical procedure that includes a housing covering an anatomical model. The model is made up of simulated tissue supported on a base assembly that allows pivoting and rotation of the simulated tissue. The simulated tissue includes a portion that represents soft tissue, such as dermal tissue, muscle, connective tissue and the like, and a portion that represents hard tissue, such as osseous tissue. The housing includes apertures through which a surgical instrument may be inserted for simulating a procedure on the simulated tissue. Cannulas may be set within the apertures.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims priority to and the benefit of U.S. ProvisionalApplication Ser. No. 61/155,096, filed Feb. 24, 2009, the fulldisclosure of which is hereby incorporated by reference herein.

BACKGROUND

1. Field of Invention

The device and method described herein concerns the field of simulatingmedical procedures. More specifically, a device is described thatprovides a modular manner of simulating different surgical procedures.

2. Description of Related Art

Some newly developed medical procedures and/or devices are sufficientlyinnovative that their practice requires experienced medicalpractitioners to undergo specific training to become proficient with thenew procedure. The training for the new medical procedures, such assurgery, may incorporate devices that model anatomy. Simulating aprocedure on a model rather than a patient is significantly safer andless expensive. A drawback of currently known models is they oftenrepresent a unique or single portion of anatomy. Additionally, currentlyknown models are typically inflexible and not adjustable for multipleorientations.

SUMMARY OF INVENTION

The device and method described herein includes a surgical simulationdevice. In an embodiment, a yoke is secured onto a disc, where the discis rotatably seated on a base. The yoke ends terminate above the discand are configurable to suspend a flexible member therebetween thatsimulates tissue. Also described is a simulation assembly havingsimulated tissue attached to a substrate. Securing the tissue to thesubstrate, by suturing or by other means, can simulate a surgicalprocedure. The yoke ends include bores that can receive fasteners forattaching the simulation assembly to the yoke. Once attached, thesimulation assembly can be rotated in the yoke about a first axis androtated about a second axis with disc rotation. Cannulas can besupported adjacent the yoke and simulation assembly to simulate asurgical procedure. Cannula supports include a housing, struts, or spansupports.

BRIEF DESCRIPTION OF DRAWINGS

Some of the features and benefits of the present invention having beenstated, others will become apparent as the description proceeds whentaken in conjunction with the accompanying drawings, in which:

FIG. 1 is a side perspective view of training for a surgical procedureusing a simulation device.

FIG. 2A is a perspective view of a simulation assembly with simulatedtissue and a substrate.

FIG. 2B is a perspective view of an alternative embodiment of asimulation assembly with simulated tissue and a substrate.

FIG. 3 is a perspective view of a simulation device and simulationassembly in a housing.

FIG. 4 is a side perspective view of a simulation device and simulationassembly in a housing and cannulas protruding through the housing.

FIGS. 5A and 5B are side perspective views of the device of FIG. 4having sutures in the simulated tissue and simulated substrate.

FIGS. 6A and 6B are side perspective views of a simulation assembly inhorizontal and vertical orientations in a housing with simulated tissuesutured to simulated substrate.

FIGS. 7A and 7B are upper and lower side perspective views of a base.

FIG. 8 is a perspective view of an example substrate with acircumscribing ring.

FIG. 9 is a side perspective view of an example of a disc.

FIG. 10 is a perspective view of an embodiment of a yoke.

While the invention will be described in connection with the preferredembodiments, it will be understood that it is not intended to limit theinvention to that embodiment. On the contrary, it is intended to coverall alternatives, modifications, and equivalents, as may be includedwithin the spirit and scope of the invention as defined by the appendedclaims.

DETAILED DESCRIPTION OF INVENTION

The present invention will now be described more fully hereinafter withreference to the accompanying drawings in which embodiments of theinvention are shown. This invention may, however, be embodied in manydifferent forms and should not be construed as limited to theillustrated embodiments set forth herein; rather, these embodiments areprovided so that this disclosure will be thorough and complete, and willfully convey the scope of the invention to those skilled in the art.Like numbers refer to like elements throughout.

With reference now to FIG. 1, an example of a surgical simulation device10 is shown in a perspective view. In this embodiment the surgicalsimulation device 10 includes a base 12 with a cylindrically shaped disc13 mounted from below. The upper surface of the disc 13 registers withan aperture formed axially through the base 12. The upper surface of thebase 12 features a central circumferential taper toward the aperture. Alateral side is formed at the outer periphery of the base 12 where itprojects substantially perpendicular to the axis of the base 12. A bore16 is shown extending laterally into the lateral side of the base 12.The disc 13 is coaxially rotatable within the base 12 and provides amounting surface for a yoke 14. The yoke 14 shown is a “U” shaped memberhaving a mid-portion mounted on the upper surface of the spindle 13. Theyoke 14 curves between the mid-portion and its opposing ends so that theopposing ends project away from the base 12. An elastic member 18 isshown looping around both ends of the yoke 14 and suspended above andperpendicular to the base 12. In other embodiments, the member 18 may befully rigid or inelastic. The elastic member 18, which in one examplerepresents connective tissue, can be readily placed on or off the yoke14 for simulating a surgical procedure. An example simulated surgicalprocedure is shown where a surgical instrument 15 is being manuallymanipulated to knot a demonstration cord 20 around the elastic member 18for drawing together both sides of the elastic member 18. The surgicalinstrument 15 and cord 20 are depicted for demonstration purposes,however actual surgical instruments and suture materials may also beincluded with the embodiment of FIG. 1.

An example of a simulation assembly 22 is shown in perspective view inFIG. 2A and having a shaped piece of simulated tissue 24 mounted on asubstrate 26. As shown, the simulated tissue 24 is generally planar andprofiled at its corner portions so that it resembles a clover leaf. Inthis example the simulated tissue 24 can represent a rotator cuff.Example materials for the simulated tissue 24 include elastomers such asrubber and foam, as well as felt, cloth, combinations thereof, and thelike. The substrate 26 includes a hemispherical upper portion 27 shownset on a cylindrical lower portion 29; the simulated tissue 24 ismounted on the upper portion. A band of simulated tissue 28circumscribes the outer periphery of the cylindrical lower portion 29.The substrate 26 can be used for simulating bone. The substrate 26material can be rigid but allow for suturing (example materials includefoam, such as a polyurethane foam) but may be made of other materials aswell such as a polystyrene or polystyrene like material.

An alternative example of a simulation assembly 22A is illustrated in aside perspective view in FIG. 2B. In this example the simulationassembly 22A includes a substrate 26A having a frusto-conical upperportion 27A and a cylindrically shaped lower portion 29A depending fromthe lower surface of the upper portion 27A. The upper portion 27A has aplanar upper surface on which simulated tissue 24 is attached. The upperportion 27A has lateral sides that taper radially outward from betweenthe upper surface to the lower surface of the upper portion 27A.

FIG. 3 provides in side perspective view an examples of the simulationassembly 22 mounted onto the yoke 14 of the simulation device 10. A ring31 is shown circumscribing the substrate 26, bores (not shown) in theyoke 14 register with bores through the side wall of the ring 31.Fasteners 30 are shown provided that extend through the registered boresin the yoke 14 and ring 31 and into the substrate 26. The fasteners 30can be threaded with matching threads in the bore in the ring 31, or canbe pin like members that pass through the bores in the ring 31.Optionally, the fasteners 30, when applied, can compress the ring 31 tobind the assembly 22 therein instead of piercing the substrate 26.

In the configuration of FIG. 3, the assembly 22 may pivot about an axisA_(X) aligned with the fasteners 31; the assembly 22 may also rotateabout an axis A_(Y) of the base 12 and the disc 13. In an example, thedisc 13 is coaxial with the axis A_(Y) and thus rotates within the base12 about the axis A_(Y). Provided with this embodiment is a housing 32shown secured to the base 12 and enclosing the simulation assembly 22.In the example illustrated, the housing 32 lower end is open andencircles the outer periphery of the base 12, the housing 32 extendsupward from the base 12 substantially parallel with the axis A_(Y) andcurves inward to form a dome like upper portion over the simulatedtissue 24. Alternatively, the housing 32 can have an upper end withother shapes, such as conical, cylindrical, or asymmetric and can havean outer surface that is uneven or includes undulations. In yet anotheralternative, the housing 32 can be clear, translucent, or opaque and/ormay include strips that have at least a portion supported in a spacearound the simulation assembly 22.

Referring now to FIG. 4, the housing 32 is equipped with apertures 36and cannulas 34 are shown inserted through the apertures 36. Thus inFIG. 4, the housing 32 serves as a support for the aperture 36.Alternatively, an aperture support can be any member for supporting anaperture 36 in space and offset from the simulation assembly 22.Examples include a planar web element having an end supported on asurface proximate the simulation assembly 32 that extends to a locationoffset from the simulation assembly 32. Grommets 38 as shown mayoptionally be set within the apertures 36. The cannulas 34, which areobtainable from most medical supply sources, provide conduits forinsertion of surgical instruments (not shown) through the housing 32 andinto the simulation assembly 22. Thus a surgical procedure can besimulated by directing cannulas 34 at the simulation assembly 22 andinserting surgical instruments through the cannulas 34 to simulate aprocedure on the simulation assembly 22. In an example, the housing 32represents patient or subject tissue through which surgical instrumentsare inserted and the apertures 36 can each represent an incision.

FIGS. 5A and 5B, which are similar to the illustration in FIG. 4,further include sutures 40 shown formed through the simulated tissue 24and the substrate 26. The sutures 40 were formed with a surgical deviceinserted through a cannula 34 mounted in the housing 32. Referring nowto FIG. 5B, the simulation assembly 22 is shown pivoted about the axisA_(X) and oriented transverse from its orientation of FIG. 5B.Accordingly, the pivoting ability of the simulation assembly 22 on theyoke 14 provides flexibility for different simulation orientations.FIGS. 5A and 5B depict simulated examples of a completed arthroscopicrotator cuff repair. In an example, the simulated tissue 24, 28represents mammal soft tissue, such as epidermis, connective tissue,muscle, tendons, ligaments, combinations thereof, and the like.Optionally, the substrate 26 represents hard tissue, such as an osseousor osseous like material.

Further orientation flexibility is demonstrated in FIGS. 6A and 6B wherethe simulation assembly 22 is shown with its lower side disposed in aplane substantially parallel with axis A_(Y) (FIG. 6A) and its lowerside facing the housing (FIG. 6B). In both views sutures 40 are providedthrough the simulated tissue 28 and the substrate 26 lower surface.FIGS. 6A and 6B portray examples of a completed glenoid labrum repair.Thus the simulation assembly 22 can be fully rotated about both A_(X)and A_(Y) axes to position the assembly 22 into any desired orientationthereby providing for a simulated surgical procedure from multipledirections.

FIG. 7A illustrates a perspective and view of an example of the base 12.The base 12 as shown is a disc-like member with its radius greater thanits length or thickness and includes an annulus 126 aligned with itsaxis. Side bores 122, 124 are shown laterally extending through the base12; side bore 124 extends from the base 12 outer periphery to theannulus 126. Vertical bores 128 are shown formed upward into the base 12from its bottom surface. A lip 129 can optionally be included on thebase 12 periphery at its lower end. The annulus 126 is showncircumscribed by a recess 127 at its lower entrance. The side bore 124may be fitted with a resilient member 125, such as a spring, and adetent element 123, wherein the member 125 urges the detent element 123from the side bore 124 into the annulus 126. FIG. 7B illustrates a sidesectional view of the disc 12. Here the lip 129 is shown extendingradially outward past the outer radius of the annulus 126.

FIG. 8 illustrates in a perspective side view an example of a substrate26 with an accompanying ring 31. The substrate 26 is shown having anupper bore 262 shown formed into the upper portion 27 of the substrate26 and substantially aligned with the axis A_(Y). The upper bore 262 canbe threaded to couple with an attachment for the simulated tissue 24(see FIG. 3). Side bores 310 are shown formed through the side wall ofthe ring 31 for coupling the ring 31 to the lower portion 29 of thesubstrate 26. The bores 310 can be smooth or threaded and dimensioned toreceive fasteners 30 therein.

A side perspective view of an example of the disc 13 is provided in FIG.9. As shown, the disc 13 includes a cylindrically shaped spindle 132 setsubstantially coaxial with an axis A_(D) of the disc 13. A disc likeflange 130 projects radially outward from the lower end of the spindle132. A slot 134 is provided on the upper surface of the spindle 132 andtransverse to the axis A_(D) of the disc 13. The slot 134, as shown, isformed to receive the mid-portion of the yoke 14. A bore 138 shownformed coaxial with the axis A_(D) extends through the spindle 132 fromthe bottom of the slot 134. A threaded fastener, not shown, can beinserted into the bore 138 to secure the yoke 14 within the slot 134.Bores 136 are illustrated formed in the outer periphery of the spindle132 and oriented generally towards the axis A_(D). The spindle 132 isinsertable into the annulus 126 of the base 12 and can axially rotatetherein. Rotating the disc 13 with respect to the base 12 selectivelyregisters the bores 136 with the side bore 124; the pushing forcesupplied by the resilient member 125 urges the detent element 123 (seeFIG. 7A) to enter an aligned bore 136 when registered with the side bore124. Applying a rotational torque onto the base 12 can disengage thedetent element 123 from the registered bore 136 enabling the disc 13 torotate within the base 12 and into a different angular orientation. Thedisengaging force required to disengage from locking detent element 123can prevent the base 12 from freely rotating about its axis A_(X). Theamount of force necessary to compress the resilient member 125 willdictate the disengaging rotational force.

FIG. 10 illustrates an example of the yoke 14 in a side perspectiveview. As shown, the yoke 14 is a generally curved member having a bore140 formed through at roughly its midsection 148. The bore 140 is shownas threaded to receive a fastener (not shown), which may be threaded,for attachment to the disc 13. The yoke 14 curves with distance from itsmidsection 148 with its ends 142 a distance apart and away from themidsection 148. The yoke 14 as shown is an elongated member having agenerally rectangular cross section. Curved recesses 146, that mayreceive the elastic member 18, are shown provided on the lateral sidesof each of the ends 142. Also shown formed on the ends are bores 144oriented towards one another and normal to the bore 140. The bores 144may be registered with bores 310 so fasteners 30 can be inserted throughthe registered bores 144, 310.

In an embodiment, a simulation assembly 22 combined with a simulationdevice 10 can be used as a trainer for shoulder arthroscopy. The use ofarthroscope and/or surgical cannulas is optional. The embodiments of thesimulation device 10, and all portions thereof, described herein can beused to perform surgical procedures such as knot tying, suturingtechniques, suture anchor insertion, suture management, rotator cuffrepair, anterior gleniod labrum (Bankart) repair, posterior gleneoidlabrum repair, SLAP repair, and combinations thereof. The simulatedtissue may be flexible and include in its composition single as well asdual density EPF foam and other bone simulation materials. Red spongerubber, neoprene, and Veltex® can be used'as simulation tissue. Colorsof the simulation tissue, or other components of the simulation device10, can be changed to match particular or desired color schemes. Thesurgical simulations can be semi-anatomic or schematic, can simulateleft or right body anatomy, can be oriented to represent “beach chair”or lateral decubitus position without repositioning the base.

It is to be understood that the invention is not limited to the exactdetails of construction, operation, exact materials, or embodimentsshown and described, as modifications and equivalents will be apparentto one skilled in the art. It is not necessary that the supports have anannular opening, optionally the supports may comprise a shoulder or besemi-circular. In the drawings and specification, there have beendisclosed illustrative embodiments of the invention and, althoughspecific terms are employed, they are used in a generic and descriptivesense only and not for the purpose of limitation. Accordingly, theinvention is therefore to be limited only by the scope of the appendedclaims.

The invention claimed is:
 1. A surgical simulation device comprising: simulated tissue; an aperture support offset a distance from the simulated tissue; an aperture formed through the aperture support and facing the simulated tissue so that when a surgical procedure is simulated on the simulated tissue, a surgical instrument is inserted through the aperture to simulate inserting the surgical instrument through an incision in tissue; and a yoke having ends coupled to the simulated tissue, and a mid-portion mounted on a selectively rotatable disc, so that when the disc is rotated the orientation of the simulated tissue can change with respect to the aperture.
 2. The device of claim 1, wherein the aperture support comprises a substantially transparent dome shaped member.
 3. The device of claim 2, further comprising a base member circumscribing the disc; a retractable detent oriented laterally inward against the disc, and bores formed through the outer lateral circumference of the disc, so that when the disc is rotated with respect to the base to register one of the bores with the detent, the detent projects into the bore to couple the disc to the base.
 4. The device of claim 2, further comprising fasteners extending coaxially from the ends of the yoke and into the simulated tissue, so that the simulated tissue is rotatable with respect to the fasteners.
 5. The device of claim 1, wherein the simulated tissue comprises simulated soft tissue and simulated hard tissue.
 6. The device of claim 5, wherein the simulated soft tissue represents a substance comprising tissue selected from the list consisting of dermal tissue, connective tissue, muscle, ligaments, and tendons.
 7. The device of claim 5, wherein the simulated hard tissue represents a substance comprising osseous tissue.
 8. The device of claim 1, further comprising a cannula inserted through the aperture.
 9. The device of claim 1, wherein the aperture support comprises a housing surrounding the simulated tissue.
 10. An anatomical model for use in simulating a surgical procedure comprising: a base; a disc in the base that is selectively rotatable with respect to the base; simulated hard tissue coupled to the disc by a yoke having a middle coupled with the disc, and ends projecting radially outward and upward from the middle portion that couple to a lateral side of the simulated hard tissue; and simulated soft tissue mounted on the simulated hard tissue and having an outer portion that can be selectively affixed to the hard tissue by a surgical procedure.
 11. The model of claim 10, further comprising a transparent support member set on the base that covers the soft and the hard tissue and apertures in the support member so that the soft and hard tissue is accessible from above.
 12. The model of claim 11, further comprising fasteners that project into the simulated hard tissue from the ends of the yoke so that the simulated hard tissue and simulated soft tissue are pivotable about an axis coaxial with the fasteners.
 13. The model of claim 10, further comprising a web element set off from the simulated soft tissue and simulated hard tissue, and an aperture through the web element for insertion of a surgical instrument to simulate a surgical procedure.
 14. The model of claim 13, further comprising a cannula inserted through the aperture.
 15. The model of claim 10, wherein the soft tissue represents connective tissue and the hard tissue represents osseous tissue.
 16. The model of claim 13, wherein the web element comprises a continuous housing enclosing the space around the simulated soft tissue and the simulated hard tissue.
 17. A device for simulating surgical procedures comprising: a base having a disc selectively rotatable about an axis; simulated tissue mounted on the disc; a substantially clear housing enclosing the simulated tissue and that comprises an open end set on the base, a portion adjacent the open end that is substantially parallel with the axis, and a curved portion distal from the open end; and an aperture formed through the portion of the housing adjacent the open end, and an aperture formed through the curved portion of the housing, so that when a surgical procedure is simulated on the simulated tissue, a surgical instrument is inserted through at least one of the apertures to simulate inserting the surgical instrument through an incision in tissue. 